This is Your Body on Anxiety
To say that 2020 has been a year is the understatement of the century. We have collectively experienced loss on a scale never seen in the modern age. Including loss of loved ones, an economic roller coaster and political chaos. Tension seems to be hanging in the air we breathe as if it were a fog looming from the swamps of the coast land. All of this has been working together to leave a level of anxiety that it seems unshakable. Constant anxiety can lead to all sorts of problems that take their toll on both our health and quality of life. The good news, the more you know, the more power you have to change a given situation.
A Few Key Players to Keep in Mind:
Stress - physiological response to something outside the body
Anxiety - mind and body's reaction
Amygdala - portion of the brain involved in identifying danger (part of the limbic system)
Endocrine System - hormonal communication system of the body
Nervous System - electrical communication system of the body
Anxiety: Stress or Disordered Nervous System
Often we aren't sure what we are experiencing when it comes to stress or anxiety. The two can be similar. According to Tanja Jovanovic, Ph.D., "Anxiety is the mind and body's reaction to stressful, dangerous, or unfamiliar situations." Seeing how this year has been like none before, it's pretty easy to understand why we might be a little on the anxious side.
Notice she says anxiety is the reaction to stressful situations. Stress itself is a physiological response to a threat in a situation. It goes something like this. A danger or perceived stress occurs. The body reacts by feeling stress. Stress is what tells our hormones to kick into fight or flight, in that way stress is a mechanism to keeps us safe. Stress was useful when we were cavemen hunting saber tooth tigers and woolly mammoths. I don't know about you, but I haven't hunted mammoths or run from saber tooth tigers. However, most of us have been living in a situation of a perceived danger since, oh say about March 2020.
The key difference between us and our ancestors is how we would burn those hormones with the saber tooth tiger. Our bodies still respond to external threats by feeling stressed, but we don't find a way to burn those hormones. We don't fight or flight, we sit with constant stressors. Over time stress turns into anxiety. Anxiety is triggered from an internal response, stress is triggered by an external threat.
When someone is experiencing this anxiety long term, meaning longer than 6 months, it can be diagnosed as one of 6 anxiety disorders. It's important to note that the goal of this post is to help understand anxiety as a whole and how it physically affects the body. If you wish to learn more about the different types of anxiety disorders, please visit the referenced pages below.
How Does Anxiety Influence Pain?
Anxiety is relentless. It is believed to be triggered in the part of the brain that was designed to keep you safe by identifying danger around you. Just to be clear, human beings have a part of their brain that is designed to identify stressors called the Amygdala. It seeks negative/dangerous situations to tell you to avoid them. The more negativity/danger/stress the Amygdala finds, the more it gets fired up. As that Amygdala becomes more active, it sends those constant signals of worry, dread and fear that characterize anxiety.
Every moment of every day that you are living, your senses are working together to send signals to your brain. The brain interprets these signals, and responds to keep a state of balance. The constant barrage of signals from anxiety to your brain and through the nervous system tells the brain it needs to make changes to keep you safe. Some of the most influential changes include elevating hormone levels.
To quote Vasiliki Michopoulos, Ph.D. "Changes in stress hormones, autonomic responses, as well as heightened systemic inflammation are all associated with anxiety disorders and negative health outcomes. These shared physiological states suggest they shared underlying biology and that anxiety may be a whole-body condition." While the author didn't specifically state the experience of pain as one of the physiological states affected by anxiety, he does mention heightened systemic inflammation.
The idea of central sensitization that was mentioned in earlier blog posts comes into play again. Anxiety puts the central nervous system in a heightened state. Akin to having a lot of dead wood and dry conditions in a forest makes a wildfire more likely, having a nervous system with nerves already under constant stimulation predisposes them to be more likely to send a signal the brain would interpret as pain.
You have most likely experienced the anxiety pain complex before, when your doctor or nurse says "little pinch" or "oh this won't hurt." Hearing those words alone almost puts people in pain before any needles ever come into the room!
One other tidbit, is that the hormonal response to central sensitization has been indicated in research to actually stop or slow the body from healing. From a research thesis published in 2013, "If the severe pain does not abate (go away), however, the system cannot maintain its normal hormone production and serum (blood) levels of some hormones may drop below normal range. Some hormones are so critical to pain control that a deficiency(lack of) may enhance pain and retard(slow) healing." What this means is that when pain reaches a certain level, the hormones that work to control the pain drop below a level necessary to bring that pain back down. Once the hormones drop too low, healing becomes difficult. This is where an intervention becomes necessary to break out of this physiological cycle.
Physiology of Massage And Anxiety Reduction
Massage therapy may be one of the oldest forms of medicine, but there's a limited amount of research surrounding the how and why of its effectiveness. There are several working theories around why massage can be beneficial in reducing or managing anxiety.
Let's revisit the central sensitization. It's well documented that massage therapy is effective at desensitizing overstimulated nerves. By desensitizing those nerves, massage may have a calming effect on the central nervous system (CNS). As the CNS becomes less sensitized, it in turn down regulates the endocrine system, turning off the stress hormone response.
Keep in mind this is a simplified explanation of several complex processes. To understand better the relationship of central sensitization and the endocrine system there are links at the end of this post to read more information on these topics.
To Recap:
Danger or perceived danger creates stress. The hormonal response to stress creates the environment for anxiety.
The Amygdala looks for danger which adds to anxiety.
Generalized anxiety lasts less than six months. Anxiety disorders last for 6 months or longer.
Anxiety creates an environment of stress on the Central Nervous System (CNS). It may even lead to central sensitization and an exaggerated pain response.
The CNS works closely with the endocrine system and the hormones related to stress and anxiety. Those hormones can be involved with a range of health problems.
Massage can help with these conditions by working to down regulate or desensitize the central nervous system to encourage healthier hormone levels. Regulated hormone levels allow a more healing environment.
Further Reading
https://www.anxiety.org/what-is-anxiety
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4107914/
https://www.health.harvard.edu/healthbeat/the-pain-anxiety-depression-connection